Provider First Line Business Practice Location Address:
128 N ALVARADO ST
Provider Second Line Business Practice Location Address:
1
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90026-4987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-804-8884
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2011